When performing a draw on a diabetic patient with small, fragile veins, and the phlebotomist misses the patient's vein twice, what should the phlebotomist do next?
Ask another phlebotomist to obtain the specimen.
Perform the draw on a foot.
Repeat the draws until the phlebotomist is successful.
Perform the draw on a leg.
The Correct Answer is A
Choice A reason:
Asking another phlebotomist to obtain the specimen is a prudent step after multiple unsuccessful attempts. It can reduce the patient's discomfort and anxiety. A fresh perspective from another professional might increase the chances of a successful draw, especially in challenging situations like small, fragile veins often found in diabetic patients.
Choice B reason:
Performing the draw on a foot is not typically recommended due to the increased risk of infection and complications, especially in diabetic patients who may have reduced sensation and slower healing in their extremities. This option should only be considered when other more proximal sites have been deemed unsuitable.
Choice C reason:
Repeating the draws until successful is not advisable as it can cause undue stress to the patient and increase the risk of hematoma or vein damage. It is essential to minimize the number of attempts to prevent patient discomfort and potential complications.
Choice D reason:
Performing the draw on a leg is another option that is generally avoided unless absolutely necessary, due to similar reasons as drawing from a foot—risk of infection and complications. Additionally, it can be an uncomfortable position for the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Warfarin does not typically require a fasting state before blood is drawn for testing. The medication's effect on clotting factors is independent of food intake. Therefore, a fasting requirement is not anticipated for patients taking warfarin unless specified for other concurrent tests.
Choice B Reason:
There is no need for an alternate antiseptic due to warfarin use. Standard antiseptic procedures are sufficient when drawing blood from patients on warfarin. The choice of antiseptic would be more influenced by patient allergies or specific institutional protocols.
Choice C Reason:
Patients on warfarin have an increased bleeding time because the medication is an anticoagulant, which means it works to prevent blood clots by thinning the blood. This can lead to prolonged bleeding after a venipuncture, and phlebotomists should be prepared to apply pressure for a longer time to ensure hemostasis.
Choice D Reason:
Placing a specimen on ice is not a standard procedure for blood samples taken for warfarin monitoring, which is typically done through a PT/INR test. This test measures the time it takes for blood to clot and is not affected by temperature in the same way that tests for certain enzymes or gases might be.
Correct Answer is D
Explanation
Choice A Reason:
Disposing of contaminated materials is a part of standard infection control practices. While it is important to dispose of materials that may be contaminated with blood or bodily fluids properly, this action is not specific to the aseptic technique used during venipuncture.
Choice B Reason:
Performing hand hygiene once daily is not sufficient for maintaining aseptic technique. Aseptic technique requires hand hygiene before and after each patient contact, especially before procedures like venipuncture to prevent the transmission of pathogens.
Choice C Reason:
Completing quality control procedures is an essential part of laboratory practice and patient safety but is not directly related to the aseptic technique of venipuncture. Quality control ensures the accuracy and reliability of test results rather than preventing infection.
Choice D Reason:
Cleansing the skin with sodium hypochlorite, or a similar disinfectant, is a critical step in aseptic technique for venipuncture. This action reduces the microbial load on the skin, thereby minimizing the risk of introducing pathogens into the bloodstream during needle insertion.
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